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Running Injury Prevention Series: Week 1

It is 2019, and the first 10 km, half marathon and marathons are just around the corner. It is the time of the year where new spandex is purchased, shoes are bought…. and physiotherapy clinics start to get busy. Yes, ‘tis true. 25- 50% of runners will experience a running related injury in 2019. We are starting to make some headway on this number, but it is not through fancier shoes. In fact as shoes have become more expensive and more cushioned and supportive, the incidence of running injuries has gone up, not down.

Over the next four weeks, we will offer you information to better understand running and how the very nature of running leads to so many injuries. We will then help you figure out what you can do, so that you can make it to the start line. What you do in your training decides if you make it to the finish line!! First of all, for those that don’t know us, let us introduce ourselves…

Who we are

We will use the first person “we” through-out the articles, but more specifically we are Dan Sivertson and Riley McQuillan. We are both physiotherapists at Pure Form Physiotherapy in Langley. Our love sports and running is really what lead us to our careers in sports physiotherapy. We get a lot of satisfaction in helping people back to feeling well after an injury set back. Physiotherapists are the “movement specialists” and so keeping people moving is a massive part of what our clinic is all about.

The Challenges of Running

There are text books on the biology and physics/mechanics of running (hence the term bio-mechanics). We have a physio friend at UBC doing his PhD on running injuries, so that shows how complex it can get! So let’s keep it pretty basic, as we are sure you have a run to get to… or some laundry to do. Running is a form of locomotion whereby a human springs off of one leg, leaps through the air, and lands on the other leg. That leg and all of its muscles and tendons act like a spring and absorb the energy from the previous leap. The energy is then converted from kinetic energy (the energy of motion), into elastic-potential energy in the leg. The “spring” (i.e. the leg), then releases that energy and helps propel the person back into the air for the next leap. Basically we run along on two pogo sticks, bouncing off of each leg and moving forward through the air. The key is to try to bounce more forward than up. The finish line is ahead of you, not above you.

This is not only a lower body thing. If the right leg is the forward one absorbing the energy as the right foot is on the ground (called stance phase, see Figure 2 below), the left arm is pumping forward.

Fig 2. Right leg on the ground as the left arm pumps, and the trunk rotates to the right.

So the leg and the arm on opposite sides of the body are moving in the same direction.That is a lot going on, and it requires a lot of strength and control through your trunk and hips to control these motions and make sure they happen correctly.The runner has to keep the pelvis facing forward so as to not get twisted to the right as the left arm pumps forward.The control of your trunk and pelvis while you move is often called “core stability” which is a term everyone has probably heard a lot about. We will endeavor to clarify what core stability is over the next few weeks.

The point of these articles is to discuss injury prevention. There are two over – arching causes of running injuries. These are intrinsic and extrinsic causes. Intrinsic causes are those that are intrinsic or “from inside of your body”. A few examples are:

Inadequate strength in the gluteal ( butt) muscles to support the pelvis as you run, leading to hip/knee/back pain

Inadequate strength in the muscles and tendons of the feet, leading to foot and shin pain

Conversely, extrinsic causes are those “from outside your body”. A few examples of these are:

Significantly changing the surface you run on, such as doing all of your runs on the beautiful beaches of Maui in February, when you normally run on the pavement of Langley.

Over the next few weeks we will get further into each of these areas to help you understand what could lead to an injury, so that you don’t become a running injury statistic. In the meantime, if you are new to running or just getting back into it after a holiday hibernation, take it slow and easy until your tendons and muscles get strong enough to support you down the road or trail. If you have a nagging injury that needs to be assessed now, we are happy to help. Sometimes small tweaks to how you run can really make a big change. You can reach us at 604-510-9900. Happy Running from Pure Form Physiotherapy!

Riley and Dan work at Pure Form Physiotherapy in Langley, at both the 72nd Ave and the 202 St locations. Through a combination of education, hands on therapy, and specific exercises we can get you moving well again.

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2 Responses

A quick question though, on the intrinsic factors you didn’t say anything about the knee area and strength, or lack thereof strength or conditioning in that area. Is this not an area of concern. If it is I hope you will talk about it in future such as how to prevent injury or good exercises to strengthen that area.

Great question. Hopefully in the newest article ( #2) you get some more info regarding this. The knee is often the “victim” of poor control around the hip. As the knee rolls (due to poor hip dynamic stability / strength), the knee gets sore. It can also cause shin, ankle pain. Thanks for your question !